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Expert Discusses Optimizing HIFU and Other Strategies in Prostate Cancer

Caroline Seymour
Published: Tuesday, Mar 13, 2018

Timothy J. Daskivich, MD

Timothy J. Daskivich, MD
Although High-intensity focused ultrasound (HIFU) is only approved in the United States for prostate tissue ablation, it has demonstrated efficacy as a treatment for patients with prostate cancer, says Timothy J. Daskivich, MD.

State of the Science Summit™ on Genitourinary Cancers, Daskivich, an assistant professor of surgery at Cedars-Sinai Medical Center, discussed optimizing the use of HIFU and other treatment strategies in the prostate cancer armamentarium.

OncLive: When will we see the widespread adoption of HIFU?

Daskivich: HIFU has been FDA approved since October 2015 for the treatment of prostate tissue. It’s now used by many academic centers across the United States for treatment of patients with prostate cancer. It's been used in Canada, Mexico, and Europe for the last 20 years to treat prostate cancer, so there's a track record elsewhere. We’re going to see more use of focal therapy as experience in the United States evolves.

What are other imaging modalities that are used?

Multiparametric MRI is an excellent modality for identifying high-grade tumors. It has a 20% miss rate. The beauty of it is that it ignores low-grade tumors. Low-grade tumors, such as Gleason 6 tumors, are ones we now watch and don't treat aggressively. Often, we don't want to find them in older men because that can lead to harmful overtreatment. Cedars-Sinai Medical Center has developed a platform for high-resolution MRI that improves resolution over multiparametric MRI by about six-fold. It identifies 60% of tumors that are invisible to multiparametric MRI. 
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